VIP International Plastic Surgery Center in KOREA - Autologous Rhinoplasty

Rhinoplasty with Autologous Tissue:
Septal cartilage / Ear cartilage / Rib cartilage / Fascia / Dermis
Advantages of
Tissue Rhinoplasty
Lowers the risk of inflammation
Prevents the risk of implant warping, skin redness,and skin thinning.
AAble to make a stable structure, which leads to natural results.
Rhinoplasty with Septal Cartilage

The septal cartilage, which is centered inside of the nose, is mainly used to support
the triangular-shaped structural cartilage for the nose tip and to fix extended cartilage to decide on the height and length of the nose tip.
It is also used to revise the nose structure and improve septal deviation, and then the rest is used for the nose bridge and glabella.
As the amount of septal cartilage is limited, the process of grafting the cartilage is very important to ensure
that a sufficient amount is extracted.

If the grafted cartilage is not enough, the shape of the nasal tip cannot form well and will not maintain for a longtime.
When there is less cartilage compared to the amount of nasal bone, the amount of cartilage that can be grafted is less.
In such case, it is necessary to extract the cartilage with the back part of the nasal bone, which requires a high technique.

Nasal septal cartilage
When only little is necessary, the nasal septal cartilage is the best material. With the width of 1-2mm,
this flat cartilage can bear considerable weight and is suitable for the strut to reinforce the columella and for other various structures.
However, the extraction of the basal septal cartilage requires know-how.
Lack of knowledge or experience can cause a number of problems because there is structural safety and limitation in obtaining a desired result with inadequate amount.
Therefore, as the proper nose surgery requires a very high technique, it is important to select the clinic that is systematic and widely experienced with know-how.
Since autologous tissue is used, the skin neither blushes nor gets thinner.
The nose tip appears natural.
Wide nostrils become oval.
The proportion of the nostrils and the upper part of the nose tip approaches
the ideal ratio of 2:1.
Wide alar base becomes narrow without incision.
Ear Cartilage Rhinoplasty

The ear cartilage has been used for nose surgery since long ago, mainly to cover the silicone at the nose tip. Most patients know this as “ear cartilage for nasal tip, silicon for nasal bridge”. In most cases of revision surgery of such patients, silicone implant is inserted to the nasal tip and the ear cartilage covers the silicone. This makes the silicone and cartilage appear at the nasal tip, resulting in thinner and flushed skin. That is why the rate of revision surgery increases.

Therefore, the ear cartilage is now used to create a nose tip or when there is not enough septal cartilage, taking the advantage of its anatomical figure. It is used for crooked nose and also for augmenting the overall nose, covered by fascia.

Nasal septal cartilage
As the ear cartilage is curved, it is not suitable for the strut to support the nasal tip,
and used mainly for graft in the nasal tip to strengthen the tip.
Rib cartilage Rhinoplasty

In general, the insertion of implant such as silicone and Gore-Tex has been broadly used to augment the nose or lengthen it. However, if the implant is used in bad condition, side effects such as infection, skin flushness, skin thinness and implant protrusion can occur.

Therefore, if the patient has lack of skin, weak cartilage and deformation, autologous tissue must be used to prevent side effects and create a natural looking nose.

In autologous rhinoplasty, septal cartilage, ear cartilage, rib cartilage, fascia, dermis, and bone ( scarum, skull) are usually used. If there is not enough ear cartilage or fascia, stronger and large amount of tissue is needed.
Especially in nose surgery, there cannot be a beautiful and refined nose just by heightening the nose bridge. The nose is the most prominent feature of the face, so the nose length, nose tip length, nostril size, ratio, and alar base width should be balanced harmoniously. Sometimes rib cartilage is also needed although the nose height remains the same. This is to lengthen the nose or to straighten the front of the nose. Therefore, if one considers that rib cartilage is useless just to increase 1 or 2mm of the nose height, it is because one does not fully understand the beauty of the nose and rhinoplasty.
Rib cartilage rhinoplasty is the best bio-architecture that makes the beautiful nose in the safest way.
No scar when extracting rib cartilage
Generally, patients are concerned about the scar that will be remain on the skin after grafting rib cartilage for rhinoplasty. However, there is no need to worry when a skillful plastic surgery specialist with ergonomic knowledge operates the surgery.
Although the incision for rib cartilage is 2 cm to 3 cm, cartilage selection, grafting method, and hi-tech suture method with special post-care leads to minimum scarring. Recently, there are a lot of patients willing to get revision surgery due to incorrect graft of cartilage from the previous surgery. In this case, the other side of the cartilage can be used and it is very important to undergo surgery from a plastic surgery specialist. In most cases, rib cartilage number 7 is grafted since it is the straightest cartilage.
Rib cartilage rhinoplasty uses rib cartilage for every part of the nose, including the nose tip, columella, nose bridge, and lower alar base (mid-face augmentation). However, there are some patients that use rib cartilage only for the nose tip and have artificial implant on the nose bridge, which causes complications such as inflammation and flushness. Therefore, the safest surgery is to use the patient’s own cartilage, not implants (i.e. silicone, Goretex, or Medpor). .

An elegant nose cannot be made only by augmenting the nasal bridge, especially for Asians who have a structurally flat nose. It will rather look awkward. Therefore, when the structure of the nose can be well structured with cartilage before augmenting the nose, a desired shape of the nose can be created.
If the rib cartilage can be used for the entire material, there will be no side effects that are seen in artificial materials.
Since the human cartilage is formed like springs interweaving each other,
it is easy to bend over when one side is carved.
Therefore, when grafting rib cartilage, high technique, such as “balanced-section” is
needed to prevent warping of the cartilage.
Since specialized anesthesia is used for the surgery, there will not be any extreme pain.
Some pain will remain for about 2 to 3 days but will become more comfortable after that.
General recovery time is about one week.
After that time period, shower, make-up, and social life are possible.
Dermis and Fascia Rhinoplasty
When the skin of the nose bridge is severely thin or when there is not enough soft tissue, dermis is used to fill up under the nose bridge. Dermis is extracted from the hip, and it is slightly uncomfortable to manage the wound after the graft. Since dermis gets absorbed very easily, it is not expected to use for nose augmentation but mainly used for insufficient thickness of skin. There is a tendency to have slightly bulbous tip after the surgery.
When the skin of the nose bridge is very thin, fascia, which is skin inside the head, is used to supplement the skin. When augmenting the nasal bridge by only the fascia, 2-3 multi-layered fascia is used to augment slightly within 1-2mm. For augmentation over 2mm, fascia covers either the cartilage or implant to thicken the skin and prevent the indication of insertion.